Individual
TANYA GONZALES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1575 WEST BOSQUE LOOOP, BOSQUE FARMS, NM 87068
(505) 459-8143
Mailing address
1575 WEST BOSQUE LOOOP, BOSQUE FARMS, NM 87068
(505) 459-8143
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
RN-78523
NM
Other
Enumeration date
09/01/2016
Last updated
11/14/2016
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